Ischemic Stroke and Cancer: Stroke Severely Impacts Cancer Patients, While Cancer Increases the Number of Strokes

Bang, Oh Young; Seok, Jin Myoung; Kim, Seon Gyeong; Hong, Ji Man; Kim, Hahn Young; Lee, Jun; Chung, Pil-Wook; Park, Kwang‐Yeol; Kim, Gyeong Moon; Chung, Chin Sang; Lee, Kwang Ho

doi:10.3988/jcn.2011.7.2.53

Cited by 107 publications

(118 citation statements)

References 33 publications

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“…Suggesting microembolic mechanisms in those patients, the incidence of high-intensity transient signals correlated significantly with d-dimer levels in patients not displaying conventional stroke mechanisms. 14 These results have recently been reviewed by Bang et al in 2011 15 ; however, neither study included a control group and both studies are still expecting replication outside South Korea.…”

Section: Strokementioning

confidence: 87%

Stroke and Cancer

Schwarzbach

Schaefer

Ebert

et al. 2012

Stroke

226

117

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Background and Purpose-The importance of cancer-associated hypercoagulability as a possible stroke etiology in patients with cancer has received relatively little attention to date. A recent study has suggested that cancer-associated hypercoagulation may be of special importance in the absence of conventional stroke mechanisms. Methods-We identified patients with ischemic stroke sequentially admitted to our stroke center with the additional diagnosis of active and malignant cancer from 2002 to 2011. By using our prospectively collected stroke, MRI, and laboratory data banks, the etiology and risk factors of stroke, types of cancer, deep vein thrombosis/pulmonary embolism, d-dimer levels, and diffusion-weighted imaging lesion patterns were compared to an age-and sex-matched control group. Patients with cancer with a conventional stroke etiology and patients with an unidentified and/or cancer-associated stroke etiology were analyzed separately. Results-One hundred forty patients with cancer and 140 control subjects were included. Unidentified stroke (P<0.001) and infarction in multiple vascular territories (P<0.001) were significantly more frequent and d-dimer levels significantly higher (P<0.05) in patients with cancer. Vice versa, risk factors such as hypertension (P<0.05) and hyperlipidemia (P<0.01) were more prevalent in control subjects. Deep vein thrombosis and pulmonary embolism were more frequent (P<0.01) and d-dimer levels higher (P<0.01) in the patients with unidentified and/or cancerassociated stroke etiology compared to the patients with cancer with a conventional stroke etiology. Lung and pancreatic cancer were significantly overrepresented and d-dimer levels higher in these patients compared with other patients with cancer (P<0.01). Conclusions-Our data confirm the concept of cancer-associated hypercoagulation as a widely underestimated important stroke risk factor in patients with cancer, especially in those with severely elevated

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Section: Strokementioning

confidence: 87%

Stroke and Cancer

Schwarzbach

Schaefer

Ebert

et al. 2012

Stroke

226

117

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“…Stroke severely impacts cancer patients, while cancer increases the risk of stroke [30] . CVD occurs commonly in cancer patients, ~15% of whom experience a thromboembolic event during the clinical course [5] .…”

Section: Discussionmentioning

confidence: 99%

Small-animal PET demonstrates brain metabolic change after using bevacizumab in a rat model of cerebral ischemic injury

Dong

Song

et al. 2014

Neurosci. Bull.

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To evaluate the effect of bevacizumab on cerebral ischemia, we used 2-deoxy-2-18 F-fluoro-D-glucose ( 18 F-FDG) small-animal positron emission tomography (PET) in the middle cerebral artery occlusion (MCAO) rat model. After baseline neurologic function tests and PET studies, MCAO Sprague-Dawley rats received bevacizumab or normal saline (controls). Weekly PET imaging and neurologic function tests showed that the 18 F-FDG accumulation in the bevacizumab group was similar to that in the controls during the fi rst 2 weeks, but lower than in controls at weeks 3 and 4. However, no difference was found in neurological scores between the groups. The number of von Willebrand factor-positive cells in the bevacizumab group was lower than that in controls. The expression of vascular endothelial growth factor was higher than in controls at week 4. These results suggested that bevacizumab does not infl uence functional recovery in this model of cerebral ischemia during a 4-week period, but inhibits vascular formation and metabolic recovery, which may be considered in cancer patients with a recent ischemic stroke.

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“…21 This present finding replicates the data found in the general population that Bang and colleagues found lung cancer to be the most common primary cancer type in patients with strokes versus those without strokes (29.2% vs 11.5%; P < .001). 22 Risk for all-cause and stroke-related mortality was higher in our cohort of patients with nonfatal hemorrhagic versus thrombotic strokes. This mirrors data from Abedini and colleagues that demonstrates a higher mortality in the context of hemorrhagic strokes in a posthoc analysis of the ALERT study.…”

Section: Discussionmentioning

confidence: 97%

Untitled

2016

Exp Clin Transplant

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Objectives: Stroke is a major cause of mortality in the general population but data regarding stroke-related hospitalization or mortality after a kidney transplant is limited. We determined risk for stroke-related episodes after a kidney transplant in a populationbased cohort study of 19 103 kidney allograft recipients in England between 2001 and 2012. Materials and Methods:The incidence of stroke-related events after a kidney transplant with pretransplant history of stroke, the incidence of stroke-related hospitalization or death among all kidney allograft recipients after a kidney transplant, and risk factors for stroke-related mortality after a kidney transplant were examined. Data were obtained from hospital episode statistics (an administrative data warehouse that contains admissions to all National Health Service hospitals in England) and is linked to the Office for National Statistics, which collects information on all registered deaths in England. Results: There were 782 nonfatal stroke-related hospitalizations and 113 stroke-related deaths (5.4% of total deaths) after a kidney transplant (median follow-up 4.4 y after a kidney transplant). Risk for allcause mortality was higher for those recipients with, compared to those without, a history of stroke (21.5% vs 10.8%; P < .001). However, risk for stroke-related mortality after a kidney transplant was no different. Kidney allograft recipients with nonfatal stroke episodes after a transplant were at a higher risk for allcause and stroke-related mortality. In a Cox regression model, pretransplant history of stroke was an independent risk factor for all-cause mortality, but not stroke-related mortality, while posttransplant hospitalization with nonfatal stroke was a risk factor for both. Conclusions: Fatal and nonfatal stroke-related events are common among kidney allograft recipients. Further research is warranted to allow better risk stratification and facilitate clinical trials for risk attenuation of stroke after a kidney transplant. Key words: Cerebrovascular accident, Death, Transplant IntroductionStroke, or cerebrovascular accidents, is one of the leading causes of mortality in the world, estimated to be the second leading cause of global death by the World Health Organization. 1 In 2010, the global absolute numbers of individuals developing their first stroke, surviving stroke, or having a stroke-related death were 16.9 million, 33.0 million, and 5.9 million, with 69% of events occurring in individuals aged greater than 65 years. 2 In addition, stroke-related disability represents a significant health burden, with disability-adjusted life years lost an estimated 102 million globally in 2010. 2 Although age-standardized rates of stroke-related mortality are decreasing worldwide, 2,3 absolute numbers are increasing and they represent a major public health burden.In the context of transplant, the effect of strokerelated morbidity or mortality after a transplant is unclear because of a lack of published data. Oliveras and colleagues observed a 10-...

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Ischemic Stroke and Cancer: Stroke Severely Impacts Cancer Patients, While Cancer Increases the Number of Strokes

Cited by 107 publications

References 33 publications

Stroke and Cancer

Stroke and Cancer

Small-animal PET demonstrates brain metabolic change after using bevacizumab in a rat model of cerebral ischemic injury

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